Cheng Yan, Li Lichao, Lv Yafei, Zhang Long, Chen Wenhua, Xu Gongda
Gansu Medical College, Affiliated Hospital, Department of Neurology, Pingliang, China.
J Med Biochem. 2024 Sep 6;43(5):696-703. doi: 10.5937/jomb0-50100.
Investigate the correlation between low-density lipoprotein (LDL) cholesterol, homocysteine and cognitive function in patients with cerebral small vessel disease (CSVD).
240 patients with CSVD confirmed by head MRI in the Department of Neurology from January 2020 to December 2023 were retrospectively included in the study. All the patients had complete blood biochemical examination, and their cognitive function was evaluated by Montreal Cognitive Assessment Scale (MoCA), and after correcting for the factor of years of education, the patients were divided into a group of normal cognition (MoCA 26, 70 patients) and a group of cognitive function (MoCA 26, 70 patients) according to the scores. After correcting for the factor of years of education, the patients were divided into the normal cognitive function group (70 cases with MoCA 26) and the cognitive dysfunction group (170 cases with MoCA <26) according to their scores. The general information of the two groups and the patients' cognitive function characteristics, including visuospatial and executive ability, naming, attention and calculation, language, abstraction, delayed memory, and orientation, were compared, and the independent influences on the occurrence of cognitive dysfunction in patients with CSVD were analyzed by two-category multifactorial logistic regression.
Compared with the group with normal cognitive function, the cognitive dysfunction group had lower years of education and higher homocysteine, and the differences were statistically significant (P < 0.05). Compared with the group with normal cognitive functioning, the cognitive dysfunction group had lower MoCA total scores, lower visuospatial and executive ability, naming, attention and calculation, language, abstraction, delayed memory, and orientation scores, and the differences were statistically significant (P < 0.05). Two-category multifactorial logistic regression analysis showed that low-density lipoprotein cholesterol (OR=2.756, 95% CI: 0.673-0.938, P=0.012) and homocysteine (OR=1.859, 95% CI: 1.024-1.324, P=0.016) were the independent factors influencing cognitive dysfunction in CSVD patients. The lower the risk of cognitive impairment in CSVD patients, the higher the plasma LDL cholesterol and homocysteine levels, the higher the risk of cognitive impairment in CSVD patients.
Plasma LDL cholesterol and homocysteine levels are associated with and may be predictors of cognitive dysfunction in patients with CSVD.
研究脑小血管病（CSVD）患者中低密度脂蛋白（LDL）胆固醇、同型半胱氨酸与认知功能之间的相关性。
回顾性纳入2020年1月至2023年12月在神经内科经头颅MRI确诊的240例CSVD患者。所有患者均进行了完整的血液生化检查，采用蒙特利尔认知评估量表（MoCA）评估其认知功能，在校正受教育年限因素后，根据得分将患者分为认知正常组（MoCA≥26，70例）和认知功能障碍组（MoCA＜26，170例）。比较两组的一般资料及患者的认知功能特征，包括视觉空间与执行能力、命名、注意力与计算力、语言、抽象思维、延迟记忆及定向力，并采用二分类多因素logistic回归分析对CSVD患者认知功能障碍发生的独立影响因素进行分析。
与认知正常组相比，认知功能障碍组受教育年限更低，同型半胱氨酸更高，差异有统计学意义（P＜0.05）。与认知正常组相比，认知功能障碍组MoCA总分更低，视觉空间与执行能力、命名、注意力与计算力、语言、抽象思维、延迟记忆及定向力得分更低，差异有统计学意义（P＜0.05）。二分类多因素logistic回归分析显示，低密度脂蛋白胆固醇（OR=2.756，95%CI：0.673～0.938，P=0.012）和同型半胱氨酸（OR=1.859，95%CI：1.024～）是影响CSVD患者认知功能障碍的独立因素。CSVD患者血浆LDL胆固醇和同型半胱氨酸水平越低，认知障碍风险越低；CSVD患者血浆LDL胆固醇和同型半胱氨酸水平越高，认知障碍风险越高。
血浆LDL胆固醇和同型半胱氨酸水平与CSVD患者认知功能障碍相关，可能是其预测指标。 1.324，P=0.016）
